A recent editorial in JAMA highlights the mHealth Screening to Prevent Strokes (mSToPS) randomized clinical trial in a discussion of the strengths and challenges of pragmatic clinical trials. The mSToPS trial, which studied patients at increased risk of atrial fibrillation who used a self-applied electrocardiogram sensor patch, found that immediate monitoring, compared with delayed monitoring, led to a higher rate of diagnosis after 4 months.

The editorial’s authors, Dr. Eric Peterson of Duke University and Dr. Robert Harrington of Stanford University, describe the mSToPS trial as an “innovative example of the potential (and challenges) inherent in a pragmatic IT trial.” The trial “scores quite high for its pragmatic approach” while offering lessons in the trade-offs that such an approach often requires.

The editorial notes that efforts like the NIH Collaboratory are bringing about innovations in health systems collaborations and clinical data platforms that “could provide the ideal setting to conduct highly pragmatic and efficient [randomized clinical trials] of the benefits, risks, and costs associated with novel health IT solutions.”